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362 Final Exam > Pediatric GI > Flashcards

Pediatric GI Flashcards

1
Q

What can you assess on a child to determine dehydration?

A

Turgor, fontanels, lack of tearing, thirst, mucus membranes, skin temperature, activity level

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2
Q

Why do children dehydrate quicker than adults?

A

They have more surface area.

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3
Q

What is watery staining stool after a child has already been potty trained?

A

Encopresis

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4
Q

What is McBurney’s point?

A

The point at which you assess for rebound tenderness with appendicitis

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5
Q

During what weeks (give range) of gestation does the lip and palate fuse? If this fusion does not ocur, what structural defect results?

A

Weeks 6-12.

Cleft Lip/Cleft Palate

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6
Q

What is the Haberman feeder used for?

A

feeding infants with CL/CP until surgery

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7
Q

What is the ESSR method used for? What does it stand for?

A

Feeding infants with CL/CP until surgery. Enlarge nipple, Stimulate sucking, Swallow, Rest

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8
Q

At what age are children with Cleft Lip given surgery to correct the condition?

A

Age 1-3 months

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9
Q

What is the purpose of the Logan bar placed over the child’s mouth after cleft lip surgery?

A

To reduce tension on the suture line

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10
Q

How should the nurse prevent crusting of the sutures after a Cleft Lip surgery?

A
  • Clean sutures with sterile cotton swab
  • Use 1/2 strength H2O2 followed by saline
  • Apply ointment to suture line
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11
Q

What is a Breck Feeder?

A

Like an eye dropper for the throat, for feeding babies with cleft lip

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12
Q

At what age is cleft palate surgically corrected?

A

It is repaired in stages between 6 months to 2 years.

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13
Q

Why are children with cleft palate susceptible to frequent otitis media?

A

Because of their open nasopharanyx

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14
Q

After a cleft palate repair, how soon is it okay to use bottles, straws, pacifiers, and spoons?

A

After 7-10 days

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15
Q

How should you protect a child from prying at his mouth after CL/CP surgery?

A

Elbow restraints and mittens

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16
Q

What type of diet should a child follow after a cleft palate repair?

A

Clear to soft diet

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17
Q

How long should the child wait to brush teeth after a cleft palate repair?

A

1-2 weeks.

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18
Q

After a feeding, what should the nurse do to protect the suture line?

A

She should make sure the child rinses mouth with water to clean the suture line.

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19
Q

What is the difference between EA (esophageal atresia) and TEF (tracheoesophageal fistula)?

A

EA is where there is a disruption between upper and lower portion of esophagus. TEF is abnormal communication between trachea and esophagus.

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20
Q

Do EA and TEF occur together or separately?

A

May occur alone or together but usually together.

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21
Q

How is EA diagnosed?

A

Unable to pass an NG tube to the stomach

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22
Q

A neonate presents with respiratory distress, difficulty feeding, excessive drooling, choking and coughing, and cyanosis. What is going on

A

Esophageal Atresia

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23
Q

Why is a G-tube placed after a surgery to correct EA/TEF?

A

Because it allows air to escape and also drain stomach content.

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24
Q

Who is more likely to be affected by pyloric stenosis? Males or females?

A

Males

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25
Q

What is the feeding procedure post op EA and TEF?

A

Initially NPO, then Total Parenteral Nutrition given via G-tube. Feeding starts with pedialyte and then advances over several days.

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26
Q

Where does stenosis occur in pyloric stenosis?

A

Between the stomach and duodenum

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27
Q

What causes irritation, further edema, and narrowing in pyloric stenosis?

A

Food

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28
Q

What happens to muscle during pyloric stenosis?

A

It becomes hardened

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29
Q

A child comes into the clinic, the mother says he usedd to regurgitate food mildly but now he is projectile vomiting after lunch. He has an olive shaped hard mass palpable on the abdomen. What do you suspect?

A

Pyloric Stenosis

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30
Q

What is a pyloromyotomy?

A

Cut the muscle of the pylorus

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31
Q

What is the treatment for pyloric stenosis?

A

Pyloromyotomy

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32
Q

What should the patient eat before the pyloromyotomy?

A

Trick question NPO lololol

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33
Q

What is the difference between gastroschisis and omphalocele (regarding the umbilicus)? What is the similarity?

A

Gastroschisis - to eitherside of umbilicus
Omphalocele - through the umby cord
Herniation of abdominal viscera through abdominal wall

34
Q

How should the nurse prevent infection in a patient with an omphalocele?

A

Cover sac with sterile gauze soaked in normal saline

35
Q

When the nurse is caring for a patient with gastroschisis/omphalocele, what is the most important vital sign to monitor?? Why ?

A

Temperature. A high T indicates infection. Low T indicates hypothermia/sepsis

36
Q

What does anal atresia look like?

A

Imperforate anus

37
Q

Which is a more serious infection risk, gastroschisis or omphalocele? Why?

A

Gastroschisis is more of a risk for infection. Omphalocle is less serious because it is still inside of a sac made of umbilicus.

38
Q

A baby has not passed meconium yet; it is the baby’s 2nd day of life. Exam reveals absent anus. What is going on?

A

Anal atresia

39
Q

A baby presents with stool in her urine and it is exiting her vagina. What is happening?

A

Anal atresia; stool is entering the bladder and vagina because of fistula in perineum.

40
Q

Why might a baby’s stool look like a ribbon?

A

Because of an anal-rectal malformation called anal stenosis

41
Q

When during pregnancy should amniocentesis be performed? (early/middle/late)

A

Middle of pregnancy to detect anorectal malformations

42
Q

When the umbilical muscle ring does not completely close, what can happen to underlying organs?

A

Hernia – protrusion through the muscle wall

43
Q

What physical actions can cause herniation?

A

Coughing, crying, straining

44
Q

When herniation causes strangulation of the underlying organ, what treatment is indicated?

A

Surgery

45
Q

Why might a child have encopresis?

A

The encopresis is usually due to impaction

46
Q

What are possible treatments for encopresis?

A

Barium enema, diet and behavior changes, clear out impacted stool

47
Q

What is Hirschspung’s Disease?

A

Absence of ganglion cells in distal bowel, results in inadequate motility

48
Q

Hirschpung’s disease is often present with what other comorbidity?

A

Down’s syndrome

49
Q

What are 4 signs of Hirschpung’s in a neonate?

A

1) no stool for 24 hours 2) poor feeding 3) abdominal distension 4) chronic constipation

50
Q

In Gastroenteritis, what part of the GI tract is inflamed?

A

Stomach, small intestine, large intestine

51
Q

What organism(s) cause gastroenteritis?

A

viruses, bacteria, parasites

52
Q

How long does gastroenteritis caused by viruses last? Bacterial caused-gastroenteritis?

A

viral cases last 1-2 days, bacterial cases a week or more.

53
Q

What are the complications following gastroenteritis?

A

Dehydration from diarrhea, electrolyte imbalance, bacteremia, sepsis, malnutrition

54
Q

How long does acute diarrhea last versus chronic diarrhea?

A

Must last for more than 2 weeks to be classified as chronic diarrhea

55
Q

What is the most common cause of childhood acute diarrhea?

A

Viral infection with rotavirus

56
Q

What iss the most caumon cause of childhood chronic diarrhea?

A

A functional disorder such as IBS, or Crohn’s or ulcerative colitis

57
Q

What med is given for diarrhea, in the case of anerobic bacteria, parasites,or H pylori?

A

Flagyl (antibiotic) and Immodium (an anti-diarrheal)

58
Q

Is diarrhea the same as unformed stool?

A

nope

59
Q

Which gender is more likely to be troubled by reccurent abdominal pain?

A

Females, usually school aged girls

60
Q

What should the nurse explore in the case of a young female with recurrent abdominal pain?

A

Pressure/stresses in the childs life

61
Q

What age group (give range) is most often affected by appendicitis? Which gender?

A

Males, ages 10-19.

62
Q

What is the physiology of appendicitis?

A

Swelling, vascular supply is compromised, bacteria followed by immune response, can lead to rupture.

63
Q

In a child with appendicitis, what 2 actions of the nurse will elicit pain?

A

Abdominal palpation produces rebound tenderness. Digital rectal exam elicits tenderness.

64
Q

What labs need to be tested to confirm appendicitis that will rule out ectopic pregnancy?

A

White blood cells will be elevated in appendicitis

65
Q

Is Meckel’s Diverticulum congenitial or acquired?

A

Congenital

66
Q

What does Meckel’s Diverticulum look like? What causes it to form?

A

Outpouching of SI –because connection between intestine and umbilical cord doesn’t completely close off during fetal development.

67
Q

What is the most common symptom of Meckel’s diverticulitis?

A

Painless bleeding from the rectum

68
Q

When the ilieus outpouches and contains gastric contents, what can happen to the lining of the ilium?

A

Ulceration, bowel obstruction, perforation or peritonitis (Meckel’s diverticulum)

69
Q

What is the Rule of 2’s regarding Meckel’s diverticulum?

A

Occurs in first 2 years of life
Involves 2 types of tissue (stomach and pancreatic)
2 feet from ileocecal valve

70
Q

What is the most common COMPLICATION of Meckel’s diverticulum?

A

Bowel obstruction

71
Q

What happens to the hepatic/common bile ducts with Biliary Atresia?

A

Closure of the hepatic or common bile ducts

72
Q

What is the most common pediatric liver disease?

A

Biliary Atresia

73
Q

What is the most common cause of infant jaundice?

A

biliary atresia

74
Q

What is cholestasis? Comorbid with what disorder of the liver?

A

Bile cannot flow from liver to duodenum. Results from Biliary atresia. Causes inflammation

75
Q

A lack of bile acids (as in biliary atresia) interferes with the absorbtion of vitamis K, A, D, and E….why these vitamins? What does stool end up looking like?

A

K A D and E are the fat soluble vitamins. Without bile acids, body develops steattorhea and nutritional deficit.

76
Q

A newborn shows up at the clinic with jaundiced sclera, abdominal distension, tea colored urine, and clay colored stool. The newborn is FTT. What do you suspect?

A

Biliary Atresia?

77
Q

When a child has biliary atresia, what labs will be elevated?

A

Bilirubin levels will be elevated, bleeding time is elevated.

78
Q

What is the treatment to correct biliary atresia?

A

Surgery to correct obstruction or liver transplatation.

79
Q

What vitamin is given to improve clotting in children with biliary atresia?

A

Vitamin A is given to improve clotting.

80
Q

A low T in a patient with gastroschisis/omphalocele indicates what?

A

Hypothermia or sepsis.

362 Final Exam (4 decks)

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